Clinical Journal of Gastroenterology最新文献_第5页

A case of esophagogastric submucosal hematoma with hemorrhagic shock. 一例食管胃黏膜下血肿伴失血性休克病例。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-11-21 DOI: 10.1007/s12328-024-02069-9

Yumiko Kaise, Kaname Uno, Yohei Ogata, Masahiro Saito, Xiaoyi Jin, Waku Hatta, Tomoyuki Koike, Hideki Ota, Kei Takase, Atsushi Masamune

{"title":"A case of esophagogastric submucosal hematoma with hemorrhagic shock.","authors":"Yumiko Kaise, Kaname Uno, Yohei Ogata, Masahiro Saito, Xiaoyi Jin, Waku Hatta, Tomoyuki Koike, Hideki Ota, Kei Takase, Atsushi Masamune","doi":"10.1007/s12328-024-02069-9","DOIUrl":"https://doi.org/10.1007/s12328-024-02069-9","url":null,"abstract":"A 70-year-old woman had been taking steroids for granulomatosis with polyangiitis since the age of 60 years and warfarin for deep vein thrombosis since the age of 63 years. She was admitted to the emergency unit of our hospital in a shock vital with complaints of sudden onset of epigastralgia, nausea, and melena. Laboratory data revealed anemia, hypoalbuminemia, and coagulation disorders. Enhanced computed tomography demonstrated extravasation in the middle part of the gastric body in an extensive submucosal hematoma extending from the upper esophagus to the entire gastric body. Emergency esophagogastroduodenoscopy depicted a large submucosal hematoma and a large amount of fresh blood in the stomach; however, active bleeding was not identified. Two sessions of interventional radiology treatment in the emergency department, followed by an intensive care, successfully treated the patient without any complications. We report a unique case of a sudden-onset esophagogastric submucosal hematoma with hemorrhagic shock requiring an intensive care and interventional radiology treatment. In this case, the extensive warfarization and the fragility in vascular and connective tissue components in the submucosa due to the long-term steroid therapy and the granulomatosis with polyangiitis-related alteration might comprehensively cause severe esophagogastric submucosal hematoma even without any apparent triggers.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of needle tract seeding of pancreatic adenosquamous carcinoma after a single endoscopic ultrasound-guided tissue acquisition. 单次内窥镜超声引导组织采集后胰腺腺鳞癌针道播种病例。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-11-21 DOI: 10.1007/s12328-024-02068-w

Taro Hanaoka, Kosuke Okuwaki, Nobuyuki Nishizawa, Masafumi Watanabe, Kai Adachi, Akihiro Tamaki, Tomohisa Iwai, Mitsuhiro Kida, Yusuke Kumamoto, Chika Kusano

{"title":"A case of needle tract seeding of pancreatic adenosquamous carcinoma after a single endoscopic ultrasound-guided tissue acquisition.","authors":"Taro Hanaoka, Kosuke Okuwaki, Nobuyuki Nishizawa, Masafumi Watanabe, Kai Adachi, Akihiro Tamaki, Tomohisa Iwai, Mitsuhiro Kida, Yusuke Kumamoto, Chika Kusano","doi":"10.1007/s12328-024-02068-w","DOIUrl":"https://doi.org/10.1007/s12328-024-02068-w","url":null,"abstract":"Needle tract seeding (NTS) is a rare complication of endoscopic ultrasound-guided tissue acquisition (EUS-TA). Herein, we report the case of an 83 year-old man who presented with a solid mass in the pancreatic tail, measuring 35 mm in diameter, with cystic degeneration. EUS-TA was performed using a 22-gauge biopsy needle, with a single puncture via the stomach; however, no definitive pathological diagnosis was achieved. Due to the strong suspicion of malignancy, surgery was performed at the patient's request, and the postoperative pathological diagnosis was pancreatic adenosquamous carcinoma. One year after surgery, computed tomography revealed a string of bead-like nodules within the gastric wall. Esophagogastroduodenoscopy revealed three submucosal, tumor-like raised lesions aligned in a row on the upper posterior wall of the gastric body. EUS detected a solid mass with cystic degeneration. Histological findings from EUS-TA specimens were consistent with those from the pancreatic resection specimen, leading to a diagnosis of NTS. Although reports of NTS have been increasing in recent years, cases of NTS occurring after only a single puncture remain extremely rare. This case clearly demonstrates that NTS can occur even after a single puncture, highlighting the importance of obtaining thorough informed consent regarding this risk prior to performing EUS-TA.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The improvement of a refractory enterocutaneous fistula with colchicine in a patient with Crohn's disease who had an MEFV gene mutation. 一名克罗恩病患者因 MEFV 基因突变，使用秋水仙碱后难治性肠瘘得到改善。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-11-20 DOI: 10.1007/s12328-024-02061-3

Yoshihiro Yokoyama, Kotaro Akita, Yuki Hayashi, Tomoe Kazama, Hiroki Kurumi, Katsuyoshi Matusoka, Hiroshi Nakase

{"title":"The improvement of a refractory enterocutaneous fistula with colchicine in a patient with Crohn's disease who had an MEFV gene mutation.","authors":"Yoshihiro Yokoyama, Kotaro Akita, Yuki Hayashi, Tomoe Kazama, Hiroki Kurumi, Katsuyoshi Matusoka, Hiroshi Nakase","doi":"10.1007/s12328-024-02061-3","DOIUrl":"https://doi.org/10.1007/s12328-024-02061-3","url":null,"abstract":"Enterocutaneous fistulas (ECFs) occurring in the setting of Crohn's disease (CD) are difficult to cure with medical treatment alone and affects a patient's quality of life. A 39-year-old man was diagnosed with an ileocolitis-type CD in 2007. His inflammation was insufficiently controlled despite the administration of an anti-tumor necrosis factor-alpha antibody. Therefore, he underwent subtotal colectomy, terminal ileal resection, and ileostomy for multiple colon and anal stenoses in Dec 2015. The patient subsequently received ustekinumab; however, purulent discharge was observed from a postoperative scar around the umbilicus in July 2019. In July 2021, enteroscopy and magnetic resonance imaging (MRI) showed an ECF extending from the small intestine to the umbilicus. Upon referral to our hospital, laboratory data showed elevated C-reactive protein (CRP) and serum amyloid A (SAA). After receiving colchicine, his purulent discharge disappeared, and his CRP and SAA levels rapidly decreased. Enteroscopy and MRI performed 1 year and 5 months after the administration of colchicine revealed ECF closure. Genetic analysis revealed that the patient harbored an MEFV exon 1 (E84K) mutation.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Alpha-fetoprotein-producing intramucosal gastric cancer found during examination of metastatic lymph nodes. 检查转移淋巴结时发现甲胎蛋白分泌型黏膜内胃癌。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-11-19 DOI: 10.1007/s12328-024-02064-0

Tomoya Sano, Takahiro Toyokawa, Mami Yoshii, Yuichiro Miki, Tatsuro Tamura, Shigeru Lee, Kiyoshi Maeda

{"title":"Alpha-fetoprotein-producing intramucosal gastric cancer found during examination of metastatic lymph nodes.","authors":"Tomoya Sano, Takahiro Toyokawa, Mami Yoshii, Yuichiro Miki, Tatsuro Tamura, Shigeru Lee, Kiyoshi Maeda","doi":"10.1007/s12328-024-02064-0","DOIUrl":"https://doi.org/10.1007/s12328-024-02064-0","url":null,"abstract":"Endoscopic resection has been applied as an absolute indication for early gastric cancer showing intramucosal cancer ≤ 2 cm in diameter, differentiated-type adenocarcinoma without ulcerative findings. We describe the case of a 76-year-old man who underwent radical gastrectomy for alpha-fetoprotein-producing gastric cancer, in which the depth of invasion was clinically diagnosed as T1a after lymph node metastases were detected. Upper gastrointestinal endoscopy revealed a type 0-IIc tumor nearly 10 mm in diameter at the antrum. Computed tomography showed a 47-mm nodule along the common hepatic artery and a 22-mm nodule in the infrapyloric area. Both were pathologically confirmed as adenocarcinoma by endoscopic ultrasound-guided aspiration. No evidence of malignancy elsewhere was seen on 18F-fluorodeoxyglucose positron emission tomography. Serum alpha-fetoprotein level was elevated. Postoperatively, microscopic examination revealed moderately differentiated adenocarcinoma confined to the mucosal layer without lymphovascular involvement. Immunohistochemical examination for alpha-fetoprotein revealed that the metastatic nodes were positive despite the primary tumor being negative. The patient died of exacerbation of myelodysplastic syndrome 5 years 8 months postoperatively with no recurrence. Our experience suggests the need for further studies to validate whether the indications for endoscopic resection can apply to alpha-fetoprotein-producing gastric cancer in the same manner as to conventional gastric cancer.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Four cases of early stage poorly differentiated non-ampullary duodenal adenocarcinoma: a case report. 四例早期分化较差的非髓质十二指肠腺癌：病例报告。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-11-19 DOI: 10.1007/s12328-024-02058-y

Koyo Kido, Yohei Ikenoyama, Shoichi Yoshimizu, Manabu Takamatsu, Arisa Ueki, Akiyoshi Ishiyama, Toshiyuki Yoshio, Toshiaki Hirasawa, Yu Takahashi, Takuji Gotoda

{"title":"Four cases of early stage poorly differentiated non-ampullary duodenal adenocarcinoma: a case report.","authors":"Koyo Kido, Yohei Ikenoyama, Shoichi Yoshimizu, Manabu Takamatsu, Arisa Ueki, Akiyoshi Ishiyama, Toshiyuki Yoshio, Toshiaki Hirasawa, Yu Takahashi, Takuji Gotoda","doi":"10.1007/s12328-024-02058-y","DOIUrl":"https://doi.org/10.1007/s12328-024-02058-y","url":null,"abstract":"Early-stage, poorly differentiated, non-ampullary duodenal adenocarcinomas are rare, and their clinicopathological features remain unelucidated. Between September 2006 and April 2022, 205 consecutive patients underwent endoscopic or surgical resection for early-stage non-ampullary duodenal adenocarcinomas at our hospital. There were no cases of poorly differentiated adenocarcinoma among the 188 cases of mucosal carcinoma. Meanwhile, among the 17 cases of submucosal invasive carcinoma, four cases were poorly differentiated adenocarcinomas. Herein, we report four cases of these carcinomas. All four lesions were reddish in color and were located on the oral side of the papilla. The gross types were either protruded (0-I) or mixed, elevated, and depressed (0-IIa + IIc). During preoperative diagnosis, submucosal invasion was suspected in all lesions, and biopsies were performed. Based on histological analyses of biopsy specimens, a diagnosis of poorly differentiated or signet-ring cell components was made in all cases, and a pancreaticoduodenectomy was performed. The median tumor size was 6.5 (range, 5-12) mm, and all lesions were poorly differentiated adenocarcinomas with submucosal invasion and lymph node metastasis. Regarding the tumor immunophenotype, one and three cases exhibited gastric and mixed gastrointestinal phenotypes, respectively. Two patients experienced metastatic recurrence; one of them died from the primary disease.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Solitary Peutz-Jeghers polyp harboring a focus of high-grade dysplasia in the colon: a case report and literature review. 结肠中藏有高级别发育不良病灶的孤立性 Peutz-Jeghers 息肉：病例报告和文献综述。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-11-13 DOI: 10.1007/s12328-024-02059-x

Takato Maeda, Tadashi Yoshizawa, Takao Oyama, Satoru Nakagawa, Yasuhisa Murai, Ryuma Machida, Nao Ishidoya, Juichi Sakamoto, Hideki Iwamura, Hirotake Sakuraba

{"title":"Solitary Peutz-Jeghers polyp harboring a focus of high-grade dysplasia in the colon: a case report and literature review.","authors":"Takato Maeda, Tadashi Yoshizawa, Takao Oyama, Satoru Nakagawa, Yasuhisa Murai, Ryuma Machida, Nao Ishidoya, Juichi Sakamoto, Hideki Iwamura, Hirotake Sakuraba","doi":"10.1007/s12328-024-02059-x","DOIUrl":"https://doi.org/10.1007/s12328-024-02059-x","url":null,"abstract":"A solitary Peutz-Jeghers (PJ) polyp is a rare hamartomatous lesion without an associated PJ syndrome. However, little is known regarding malignancy arising in solitary PJ polyps. Here, we report a case of a solitary colonic PJ polyp with focal dysplasia. A 45-year-old asymptomatic man underwent total colonoscopy following a positive fecal occult blood test. The patient had no history of mucocutaneous pigmentation or family history of PJ syndrome. A 20 mm erythematous pedunculated polyp was observed in the sigmoid colon. Magnified endoscopy revealed a tubular or branch-like pit pattern with localized areas of irregular pits. These findings were suggestive of colorectal adenoma with high-grade dysplasia, and endoscopic mucosal resection was performed. Histopathological examination revealed arborizing proliferation of hyperplastic epithelia with smooth muscle bundles. In addition, a small number of irregular crypts with high-grade dysplasia were observed in the hyperplastic epithelium. Based on these histological findings, we finally diagnosed the patient with a solitary colonic PJ polyp with high-grade dysplasia. The present case suggests that solitary colonic PJ polyps may harbor dysplastic changes and require pathological evaluation with en bloc resection of the polyps.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A ring-shaped gas sign: a case of the accidental ingestion of a press-through package. 环形气体标志：一个误食压穿包装的案例。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-11-12 DOI: 10.1007/s12328-024-02060-4

Dai Kubota, Yosuke Tsuji, Yoku Hayakawa, Mitsuhiro Fujishiro

引用次数: 0

Diagnostic dilemma: a collision of pancreatic neuroendocrine tumor G3 and adenocarcinoma with extensive fibrosis. 诊断难题：胰腺神经内分泌肿瘤 G3 和腺癌并发广泛纤维化。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-11-10 DOI: 10.1007/s12328-024-02057-z

Daichi Hayashi, Masashi Yamamoto, Dai Nakamatsu, Kengo Matsumoto, Koji Fukui, Shiro Adachi, Tsutomu Nishida

{"title":"Diagnostic dilemma: a collision of pancreatic neuroendocrine tumor G3 and adenocarcinoma with extensive fibrosis.","authors":"Daichi Hayashi, Masashi Yamamoto, Dai Nakamatsu, Kengo Matsumoto, Koji Fukui, Shiro Adachi, Tsutomu Nishida","doi":"10.1007/s12328-024-02057-z","DOIUrl":"https://doi.org/10.1007/s12328-024-02057-z","url":null,"abstract":"An 82-year-old man presented with intermittent abdominal pain and elevated liver enzymes. Blood tests showed normal levels of tumor markers (CEA, CA19-9, NSE). Contrast-enhanced computed tomography (CE-CT) revealed a 20 mm hypovascular mass in the pancreatic head. Magnetic resonance imaging indicated low intensity on both T1- and T2-weighted images and high intensity on diffusion-weighted images. Endoscopic ultrasonography visualized an irregular hypoechoic mass. Initially, it was diagnosed as pancreatic ductal adenocarcinoma (PDAC) based on imaging. Subsequent histopathological analysis via endoscopic ultrasound-guided fine-needle aspiration revealed a neuroendocrine tumor (NET). The preoperative diagnosis was changed to a pancreatic NET grade1. Consequently, a pancreaticoduodenectomy was performed. Histopathological examination of the resected specimen unveiled a mixed tumor-NET-Grade1/Grade3 and invasive PDAC. No clear transition between the NETs and PDAC was observed. The high grade of NET with significant fibrosis contributed to decreased enhancement of CE-CT. Finally, we diagnosed this case as a pancreatic collision tumor involving both NET and PDAC components, with lymph node metastases attributed to the NET components. In this case, achieving an accurate preoperative diagnosis was challenging despite utilizing both imaging and biopsy diagnostics. This unique case underscores the difficulties encountered in the preoperative assessment of mixed tumors.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

S-1/irinotecan/oxaliplatin chemotherapy achieved a pathological complete remission in advanced pancreatic carcinoma. S-1/伊立替康/奥沙利铂化疗实现了晚期胰腺癌的病理完全缓解。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-11-06 DOI: 10.1007/s12328-024-02055-1

Ru Chen, Tomohisa Iwai, Hiroshi Tajima, Kai Adachi, Kosuke Okuwaki, Masafumi Watanabe, Taro Hanaoka, Akihiro Tamaki, Yusuke Kumamoto, Chika Kusano

{"title":"S-1/irinotecan/oxaliplatin chemotherapy achieved a pathological complete remission in advanced pancreatic carcinoma.","authors":"Ru Chen, Tomohisa Iwai, Hiroshi Tajima, Kai Adachi, Kosuke Okuwaki, Masafumi Watanabe, Taro Hanaoka, Akihiro Tamaki, Yusuke Kumamoto, Chika Kusano","doi":"10.1007/s12328-024-02055-1","DOIUrl":"https://doi.org/10.1007/s12328-024-02055-1","url":null,"abstract":"Chemotherapy has been developed for many years for malignancies, including advanced pancreatic cancer, downsizing the primary site, thereby enabling complete cure with the combination of conversion surgery. Pathological complete remission from operation samples was usually identified as a promising indication for a good prognosis for many carcinomas. Several case reports consisting of pathological complete remission after chemotherapy application have been reported but no case of pathological complete remission that resulted from successful extensive resection by surgery after S-1, irinotecan, and oxaliplatin (SIROX) chemotherapy. A 48-year-old male patient was hospitalized due to abdominal pain which turned out to be a 25 mm-sized advanced uncinate process of pancreatic cancer with possible duodenum invasion and hepatic metastasis. The tumor had decreased after administering 23 sessions of modified SIROX chemotherapy, and he underwent pylorus-preserving pancreaticoduodenectomy with portal vein resection. He was successfully managed with conservative treatment and discharged 12 days postoperatively despite his postoperative weakness. He had been taking S-1 pills for 6 months and until now, 3 years postoperatively, with no relapse. The final pathology reported complete tumor regression. Therefore, we emphasize the oncologic significance of chemotherapy in the uncinate process of pancreatic cancer and the potential role of conversion surgery.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The first case of primary malignant melanoma of the esophagus to achieve pathologic complete response after preoperative ipilimumab + nivolumab followed by resection. 首例食管原发性恶性黑色素瘤患者在术前使用伊匹单抗+nivolumab并切除食管后获得病理完全反应。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-10-31 DOI: 10.1007/s12328-024-02050-6

Ryo Shibayama, Kentoku Fujisawa, Yusuke Ogawa, Hayato Shimoyama, Yu Ohkura, Aya Honda, Shusuke Haruta, Harushi Udagawa, Masaki Ueno, Yutaka Takazawa

{"title":"The first case of primary malignant melanoma of the esophagus to achieve pathologic complete response after preoperative ipilimumab + nivolumab followed by resection.","authors":"Ryo Shibayama, Kentoku Fujisawa, Yusuke Ogawa, Hayato Shimoyama, Yu Ohkura, Aya Honda, Shusuke Haruta, Harushi Udagawa, Masaki Ueno, Yutaka Takazawa","doi":"10.1007/s12328-024-02050-6","DOIUrl":"https://doi.org/10.1007/s12328-024-02050-6","url":null,"abstract":"Primary malignant melanoma of the esophagus is a rare disease with a poor prognosis. Surgical resection is common, but there is no consensus on perioperative treatment. Studies have reported the efficacy of programmed cell death-1 inhibitors (e.g., nivolumab, pembrolizumab) and anti-cytotoxic T-lymphocyte-associated antigen 4 agents (e.g., ipilimumab) in treating malignant melanoma. Here, we present the first case of primary malignant melanoma of the esophagus with lymph node metastases treated with nivolumab and ipilimumab followed by resection, achieving a pathologic complete response. A 75-year-old man presented with dysphagia. Esophagogastroduodenoscopy revealed a black, elevated lesion in the mid-thoracic esophagus. Biopsy confirmed primary malignant melanoma of the esophagus, showing tumor cells with melanin deposition, positive for HBM45 and S-100 staining. Computed tomography showed enlarged lymph nodes in the subclavian and mediastinum regions, suggesting metastases. After two courses of preoperative chemotherapy with ipilimumab and nivolumab, which significantly shrank the tumor, the patient underwent robot-assisted subtotal esophagectomy and 3-field lymph node dissection. Histopathological examination revealed no tumors or lymph node metastases, confirming a pathologic complete response. Given the rarity and poor prognosis of primary malignant melanoma of the esophagus, this case provides valuable insights for treatment strategies.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0